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Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
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Published on: June 25, 2013

Methods for reducing peak pressure in laparoscopic grasping.

Jasper Bos1, Ernst W L J Doornebosch, Josco G Engbers

  • 1Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands.

Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
|September 18, 2013
PubMed
Summary
This summary is machine-generated.

Rounding laparoscopic grasper edges significantly reduces tissue-damaging pressures. Even metal graspers with rounded edges prevent tissue damage, suggesting soft materials are unnecessary for safe tissue retraction.

Keywords:
Biological tissuesYoung’s modulusbiomedical engineeringend effectorgrasperlaparoscopysilicone rubbersurgerytissue damage

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Published on: August 2, 2016

Area of Science:

  • Biomedical Engineering
  • Surgical Instrumentation
  • Materials Science

Background:

  • Laparoscopic graspers can exert damaging pressures during tissue retraction.
  • Previous studies indicate edge rounding or silicon sleeves reduce peak pressures.
  • Optimal grasper design for minimizing tissue damage requires further investigation.

Purpose of the Study:

  • To investigate the effects of end effector material properties and geometry on tissue pressure.
  • To determine the influence of Young's modulus, edge curvature, and pulling angle on generated pressure.
  • To identify grasping strategies that effectively limit tissue damage during laparoscopic procedures.

Main Methods:

  • Artificial skin and pressure-sensitive film were used to simulate tissue grasping.
  • End effectors with varying Young's moduli (0.09 MPa to 69 GPa) and rounded/non-rounded edges were tested.
  • Tests were conducted under a constant load (13 N) and varied pulling angles (25°, 50°, 75°).

Main Results:

  • For non-rounded graspers, pressure increased with Young's modulus and pulling angle.
  • Rounded end effectors showed significantly lower pressures, with the second lowest Young's modulus yielding optimal results.
  • Pressures remained below the tissue damage threshold for all rounded end effectors, regardless of material stiffness.

Conclusions:

  • Rounding the edges of laparoscopic graspers is a highly effective method for preventing tissue damage.
  • Soft, flexible materials may not be necessary; stiff metal graspers with rounded edges can suffice.
  • Gr تصميم design modifications, specifically edge curvature, are critical for improving surgical safety in laparoscopic procedures.